January 2015

January 2015—A task force of the American Society of Cytopathology in 2009 began the work involved in developing workload recommendations for cytotechnologists who screen image-guided Pap tests. The available data strongly suggested that Pap test screening workloads, as currently approved by the FDA and practiced in some laboratories, are too high and may represent a patient safety risk for the women whose Pap tests are reviewed under those conditions.

January 2015—It’s a somewhat stark fact: When hospitalized cancer patients die from something other than cancer, the cause is most likely to be venous thromboembolism. But there is a degree of mystery about why some cancer patients are more prone than others to be afflicted with VTE.

January 2015—As new technology is incorporated into practice and health care reimbursement models evolve, the field of pathology continues to transform. For example, in gynecologic cytopathology, Papanicolaou testing is declining as molecular testing for human papillomavirus is incorporated into cervical cancer screening. This has an adverse impact on daily cytotechnology workload. Simultaneously, decreased reimbursement is affecting pathology practices, and questions have been raised about potential shortfalls in the future pathologist workforce.

January 2015—Molecular genetics laboratories in the U.S. are doing a great job. Ten-year data from the molecular genetics Surveys in the CAP proficiency testing program show that U.S. clinical laboratories are making extremely accurate calls using molecular genetics assays. At the 2014 meeting of the Association for Molecular Pathology, Karen E. Weck, MD, and Iris Schrijver, MD, presented results from seven of the proficiency Surveys that the CAP/ACMG Biochemical and Molecular Genetics Resource Committee oversees. Dr. Weck is the chair of the committee; Dr. Schrijver is past chair.

January 2015—CAP TODAY’s 2015 guide to coagulation analyzers begins here. Diagnostica Stago last year released rivaroxaban and apixaban calibrators and controls (research-use only) for automated anti-Xa activity assessment. It expects in the coming months to submit them for 510(k) clearance, says Nichole Howard, Stago’s communications specialist. The company will soon release the automated ecarin chromogenic assay for dabigatran (RUO).

January 2015—Dark matter is shrinking—at least in the thyroid cancer part of the universe. Until recently, the percentage of papillary thyroid carcinomas with no known oncogenic drivers hovered around 25 percent. Now, with the publication of the most recent research effort by The Cancer Genome Atlas project, that number has shrunk considerably, to about 3.5 percent.

January 2015—Ebola virus disease had taken 6,900 lives in West Africa and exactly one in the United States as of Dec. 18, 2014. The World Health Organization in August had declared the West African crisis to be a public health emergency of international concern. Yet EVD received little attention in the U.S. until a patient who had traveled from Liberia was diagnosed at Texas Presbyterian Hospital in Dallas on Sept. 30 and died eight days later.

January 2015—While no one would question the virtues of accurate laboratory results, a recently concluded Q-Probes study is a new reminder that alone they’re not enough. Results should be reviewed before a lab goes live with a new interface that transmits results to the electronic health record, as well as when changes are made at the laboratory or EHR level that could alter test resulting. They also should be reviewed periodically, say the authors of the study, titled “Validating Laboratory Results in Electronic Health Records.”

January 2015—Last year was the first year that the American Board of Pathology offered Maintenance of Certification Part III subspecialty examinations. Sixty-four diplomates took a pilot exam in 2013, but it included only anatomic pathology and clinical pathology modules. The secure examination may be taken in years seven to 10 after enrollment in MOC, with no more than 12 years elapsing between examinations. All 2014 examinations were given in Tampa, Fla., but there are plans to offer testing in other locations in the future.

January 2015—Do you need a proficiency testing tool for your pathologists and cytotechnologists who perform rapid on-site evaluation? Could you benefit from fine-tuning your cytopathology interpretive skills for the assessment of CT- and ultrasound-guided core biopsies and fine-needle aspirations? Are you looking for a new tool to enhance intraoperative consultation and shorten turnaround time? Why not try the online Touch Imprint/Crush Preparation Program?

January 2015—Fine-needle aspiration plays a large role at many institutions in the diagnosis of head and neck cancers, and aspiration of enlarged cervical lymph nodes in older individuals is among the more common requests for cytology services. Being that squamous cell carcinoma is by far the most common epithelial malignancy of the head and neck region and that cervical lymphadenopathy in older individuals is one of the more frequent initial manifestations, optimizing these aspirations to direct patient care is a worthy goal.

January 2015—Age-related mutations linked to clonal hematopoietic expansion and malignancies: A common practice in molecular profiling of tumors is to subtract mutations detected in DNA derived from blood (representing germline or inherited polymorphisms) from mutations detected in DNA derived from the paired tumor to assess the tumor’s somatic molecular profile.

January 2015—Platelet transfusion: an AABB clinical practice guideline. Despite long-standing prophylactic use of platelet transfusions, an appropriate transfusion threshold has been a matter of debate. In particular, better data from newly emerging clinical studies has been a focus of this evolving debate.

January 2015—Are amended surgical pathology reports reaching the correct care provider? Amended reports need to follow patients to treating physicians to avoid erroneous management based on an original diagnosis. The authors undertook a study to determine if amended reports followed patients appropriately. They tracked amended reports with diagnostic changes and discrepancies between ordering and treating physicians.

January 2015— How can we establish or verify our PT and APTT reference intervals? Is it necessary to verify the reference interval with each new reagent lot? Does the CAP recommend mentioning “mean normal PT” with patients’ results?

January 2015—Digitized slides spur patient engagement, ‘allow for democratized medicine’. Regulatory and reimbursement hurdles are key factors blocking broader adoption of digital pathology. But the technology is already having an impact, enabling patients to grasp a firmer hold of the wheel in directing their care, said Keith J. Kaplan, MD, a pathologist and laboratory medical director in Charlotte, NC.

January 2015—This year will bring a host of regulatory, coding, billing, and payment changes that are going to challenge pathologists and laboratory administrators to move quickly or else face declining revenue and the grim specter of Medicare recovery audits. That was the somber consensus of three experts gathered for a December webinar hosted by The Dark Report.

January 2015—If a picture is worth 1,000 words, what are 300 solid-organ transplant biopsy slides worth? Don’t bother doing the math. No matter how you calculate it, the new Atlas of Transplant Pathology—which features more than 300 illustrations and is available this month from CAP Press—represents a wealth of concrete, up-to-date information on the pathologic diagnoses seen in heart, kidney, liver, lung, and pancreas transplants.

January 2015–Review the final pathology-related Medicare relative value units for 2015, as detailed in the Centers for Medicare and Medicaid Services final physician fee schedule, released Dec. 23, 2014.

January 2015—Desire to stem lab test overuse leads to free software: For Zia Uddin, PhD, enough was enough. After reading time and again about the proliferation of redundant and otherwise medically unnecessary laboratory testing in the U.S. health care system, the clinical chemist and computer scientist decided to take matters into his own hands—quite literally.